Clinical analysis of patients with SARS-CoV-2 encephalitis confirmed by next-generation sequencing of cerebrospinal fluid
10.3969/j.issn.1002-0152.2024.09.002
- VernacularTitle:脑脊液二代基因检查确诊SARS-CoV-2脑炎临床分析
- Author:
Chong NIE
1
;
Zheng LUO
;
Shiding JIANG
;
Gangan LIU
;
Daojun HONG
;
Lianqun WANG
;
Yiyi ZHOU
Author Information
1. 南昌大学江西医学院第一附属医院神经内科,江西省临床医学科学院神经病学研究所,南昌大学江西医学院第一附属医院罕见病中心,南昌大学江西医学院江西省卫生健康委员会罕见神经系统疾病重点实验室(南昌 330006)
- Keywords:
SARS-CoV-2;
Encephalitis;
Meningitis;
Clinical characteristics;
Second generation sequencing(NGS);
Consciousness disorder;
Mental disorder;
Epilepsy;
Quadriplegia;
Headache
- From:
Chinese Journal of Nervous and Mental Diseases
2024;50(9):525-532
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical features,diagnostic methods,and treatment strategies for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)encephalitis confirmed through cerebrospinal fluid(CSF)analysis.Methods The clinical data of patients diagnosed with SARS-CoV-2 encephalitis through CSF analysis in the Neurology Intensive Care Unit of the First Affiliated Hospital of Nanchang University from March 2022 to March 2023 were collected.Additionally,the relevant literature published in both domestic and international databases was analyzed and synthesized.Results The main neurological manifestations of five cases included decreased consciousness(5/5),psychiatric disorder(2/5),seizures(2/5),quadriplegia(1/5),and headaches(1/5).Two cases had abnormal brain magnetic resonance imaging(MRI)changes,involving the temporal lobe,insular lobe,thalamus,hippocampus,and pons.Additionally,CSF analysis showed mildly elevated protein levels in two cases.Next-generation sequencing(NGS)of the CSF identified SARS-CoV-2 in all five cases(sequence:41-1620),and human herpesvirus 1 in one case(sequence:21).The treatment regimen for all cases included antiviral therapy,three were additionally treated with glucocorticoids and one received immunoglobulin therapy.All cases achieved a favorable outcome(mRS:0-2).Conclusion SARS-CoV-2 has the potential to induce encephalitis/meningitis due to its neurotropic nature.The consideration of this condition is warranted in patients with relevant epidemiological history and symptoms related to the central nervous system.CSF NGS serves as a valuable tool for early diagnosis,while active antiviral therapy and immunotherapy may improve patient outcomes.
